Background: Human U three protein 14a (hUTP14a) is a nucleolar protein which promotes carcinogenesis by causing degradation of the tumor suppressor protein, p53.Aims: This study aimed to investigate hUTP14a expression in hepatocellular carcinoma (HCC) and its value as a predictor for HCC recurrence after treatment with microwave ablation (MWA).Materials and Methods: The hUTP14a expression was evaluated using immunohistochemistry on ultrasound-guided fine needle aspiration biopsy material from the tumor and the surrounding cirrhotic nontumor tissues. The relation between hUTP14a expression and clinic-pathologic variables was analyzed.Results: Nuclear hUTP14a showed significant high expression in HCC tumor tissue compared with corresponding nontumor tissue (P < 0.001). Tumoral hUTP14a expression was significantly higher in patients who experienced recurrence than those who were recurrence-free after MWA (P < 0.001). Conclusion:We concluded that, hUTP14a has an oncogenic potential, as it is highly expressed in HCC tissues compared with surrounding nontumor cirrhotic tissues. Moreover, nuclear hUTP14a could be used as a promising prognostic biomarker for prediction of HCC recurrence after treatment with MWA.